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General NPI Number Information
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NPI Number | 1700798782
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Entity Type | Individual
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Provider Name | JULIANNE RENEE INGRAM FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 6709 ACADEMY RD NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3363
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Country | US
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Telephone | 505-514-0767
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Fax | 866-913-0013
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Provider Business Mailing Address
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Address Line | 1620 N MAIN ST
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City | SPANISH FORK
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State | UT
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Zip | 84660-1008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 92035
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License Number State | NM
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